U.S. Pat. No. 5,562,619 (Mirarchi, et al.) describes a deflectable catheter that may be inserted percutaneously and advanced through the vasculature to access the heart or brain. An elongated wound wire coil extends through a hollow catheter body, such coil being constructed and arranged to enable the catheter body to withstand reactive compressive load without distortion during application of tension on the pull wire and to transmit torque from the proximal to the distal tip portion of the catheter to enhance fidelity of rotational positioning of the distal tip in response to rotational orientation of the proximal portion of the catheter. The coil is in frictional torque-transmitting relationship with the interior of the hollow shaft substantially along the common length of the catheter body when the catheter is bent. This deflectable catheter purportedly has augmented throw for one-handed operation.
U.S. Pat. No. 6,755,812 (Peterson et al.) describes a deflectable, telescoping guide catheter having an inner guide with a pre-formed distal tip, an outer guide with a predetermined deflection location, and a proximal actuator. The inner guide can be longitudinally extended and axially rotated relative to the outer guide. The proximal actuator can adjustably change a bend angle of the predetermined deflection location. The catheter can be deployed with the inner guide retracted inside the distal end of the outer catheter. The extensible and rotatable inner catheter can be combined with the adjustable bend angle of the outer guide to provide an improved system for accessing and cannulation of venous structures.
U.S. Pat. No. 5,195,168 (Lundquist, et al.) describes a steering mechanism for use in a variety of medical catheters. Such steering mechanism includes a steering shaft coupled to a controller which manipulates the distal end of the steering shaft. The steering shaft includes a flexible coiled spring having a lead spring fixed in position with respect to a distal end thereof in the distal end of the steering shaft. The distal ends of one or more steering wires is/are affixed to the lead spring. The steering wires extend through the steering shaft to the controller, and the steering apparatus of the controller is used to place tension on the steering wire(s). The attachment of the distal ends of the steering wires to the lead spring may be opposite one another or may be offset for providing greater maneuverability. Tension may be placed on the steering wires by wedges mounted transversely to the controller housing, or by rotation of a shaft mounted transversely to the controller housing, the steering wires being attached to the shaft such that rotation in one direction tenses one steering sire, and rotation in the other direction tenses the other steering wire. Two independently rotatable shafts may be used to separately control the two steering wires. The steering shaft is adapted for insertion into a lumen of a catheter for use in guiding the distal end of the catheter to a treatment site within a patient. The steering mechanism may also be used in conjunction with tools or apparatus which must reach into difficult locations, such as engines or other machines.
U.S. Pat. No. 5,733,248 (Adams et al.) describes a universal guide catheter that has a shaping mandrel inserted into a lumen of the catheter. The shaping mandrel changes from a first configuration to a second configuration after the catheter has been inserted into the body. In some embodiments the shaping mandrel is formed of a shape memory material which changes from the first shape to the second shape as the catheter warms to body temperature.
U.S. Pat. No. 6,585,717 (Wittenberger et al.) describes a deflection mechanism for a medical device comprising a plurality of rings and a connecting structure connecting the plurality of rings. This deflection mechanism is purportedly that are positionable in a catheter or other flexible body to cause a distal portion of the catheter or other flexible body to deflect or curve in more than one direction in a single plane and/or in more than one plane and/or to be deflected more than 360 degrees to form a loop.
U.S. Pat. No. 6,890,329 (Carroll et al.) describes another deflection mechanism that is purportedly capable of deflecting portions of a catheter or other flexible body in more than one direction in a single plane and/or in more than one plane and/or in a curve of more than 360 degrees to form a loop.
Also, Mols, B., Moveable Tool Tip for Keyhole Surgery, Delft Outlook, Vol. 3, Pages 13-17 (2005), describes a moveable tip which incorporates a spring and one or more pull cables to facilitate deflection or steering of the tip of the device before or after insertion into a patient's body during keyhole (e.g., laparoscopic) surgery.
Additionally, Piers et al., A Flexible Distal Tip With Two Degrees of Freedom for Enhanced Dexterity in Endoscopic Robot Surgery, Proceedings 13th Micromechanics Europe Workshop, Pages 271-74 (2002) describes a flexible tube that can be bent by pulling cables running along its length. An outer tube formed on NiTi alloy is disposed on a distal portion of the flexible tube and is cut into a series of rings connected by thin elastic joints.
Also, a number of deflectable guide catheters are on sale and in public use, including for example, the Morph™ Vascular Access Catheter (BioCardia, South San Francisco, Calif.) which is intended to serve as a conduit for access in the coronary vasculature and chambers of the heart and the Attain® Deflectable Catheter Delivery System (Medtronic, Inc., Minneapolis, Minn.) which is intended for use in coronary sinus cannulation and delivery of electronic pacing leads.
Recently, a transnasal, catheter-based procedure has been developed for treating sinusitus and other disorders of the ear, nose throat and paranasal sinuses (Balloon Sinuplasty™ Procedure; Acclarent, Inc., Menlo Park, Calif.). In this procedure, an appropriately shaped guide catheter having a fixed distal curve is selected from a series of available guide catheter shapes, and the selected guide catheter is advanced though a nostril to a position where the distal end of the guide catheter is adjacent to the ostium of a paranasal sinus. A guidewire is ten advanced through the guide catheter and into the paranasal sinus. Thereafter, a balloon catheter is advanced over the guidewire and through the guide catheter, to a position where the balloon is within the ostium of the paranasal sinus. The balloon is then inflated causing enlargement and restructuring of the ostium, thereby improving sinus drainage. At present, the sinus guide catheters are commercially available in a variety of fixed shapes having distal curves from 0 degrees to 110 degrees (Relieva® Sinus Guide Catheters, Acclarent, Inc., Menlo Park, Calif.). The surgeon typically selects a sinus guide catheter which has a fixed distal curve that is believed to be best for accessing a particular sinus ostium. The fixed distal; curvature of the selected sinus guise catheter cannot be changed while the guide catheter is inserted in the subject's nose.
U.S. patent application Ser. Nos. 11/037,548; 11/150,847; 11/193,020 and 11/436,892, of which this application is a continuation in part, describe the use of deflectable or steerable guide catheters in the performance of the Balloon Sinuplasty™ procedure as well as various other procedures wherein deflectable or steerable guide catheters are used to guide devices (e.g., guidewires, catheters, implantable drug delivery devices, etc.) to desired locations within the ear, nose, throat or cranium.
There remains a need for further development of new deflectable guide catheters having variable shapes and their methods of manufacture and use for transnasal and/or other applications.